IMPACT OF A PHARMACIST-LED PATIENT EDUCATION INITIATIVE ON GLYCEMIC CONTROL OF PATIENTS WITH TYPE 2 DIABETES MELLITUS: A SINGLE-CENTER EXPERIENCE IN WEST JAKARTA, INDONESIA

Objective: This study aimed to evaluate the effect of the provision of drug-related information and patient education booklets on the hemoglobin A1c(HbA1c) levels of patients with type 2 diabetes mellitus.Methods: This prospective study was conducted at the Kembangan Health Center, West Jakarta, Indonesia, from March to June 2017. A total of30 patients were divided into two equal groups: In addition to routine treatment, patients in the intervention group received drug-related informationand patient education booklet, while those in the control group received no additional intervention. The provision of drug information was throughdirect education as well as through telephone, short messages, and booklet. HbA1c level was measured as a surrogate measure of treatment adherence.HbA1c concentration was measured at baseline and 11 weeks after the intervention.Results: Mean HbA1c level in the intervention group decreased from 8.05±0.91% at week 0 to 6.92±0.47% at week 11 after intervention (p<0.05).Conclusion: In this study, provision of drug information and patient education booklets helped to improve the patient compliance

COST-EFFECTIVENESS ANALYSIS OF CEFTRIAXONE AND NON-CEFTRIAXONE ON TYPHOID FEVER PATIENTS

Objective: This study aimed to evaluate the cost-effectiveness of ceftriaxone and non-ceftriaxone therapies in patients with typhoid fever.Methods: The applied method was a cost-effectiveness analysis. Data were retrospectively collected, and sampling was performed using totalsampling based on medical records and hospital information systems. Subjects were limited to patients diagnosed with typhoid fever and usingceftriaxone or non-ceftriaxone antibiotics. A total of 15 patients were investigated, comprising 10 patients on ceftriaxone and five patients using nonceftriaxoneantibiotics. Effectiveness was evaluated by the length of hospitalization. The cost was a median of total costs, consisting of the cost of thedrug, concomitant drugs, medical equipment, laboratory tests, doctor, health-care services, and hospitalization.Results: The results showed the effectiveness of ceftriaxone (3.80±0.789 days) did not differ with the non-ceftriaxone drugs (3.40±1.635 days).However, the total cost of ceftriaxone (Rp 1,929,355) was less than that of non-ceftriaxone antibiotics (Rp 2,787,003). The average cost-effectivenessratio of ceftriaxone group (Rp 507,725/effectiveness) was lower compared to the non-ceftriaxone (Rp 819,707/effectiveness).Conclusions: This study results showed that ceftriaxone was more cost-effective than non-ceftriaxone antibiotics

TYROSINASE INHIBITION, 2,2-DIPHENYL-1-PICRYLHYDRAZYL RADICAL SCAVENGING ACTIVITY, AND PHYTOCHEMICAL SCREENING OF FRACTIONS AND ETHANOL EXTRACT FROM LEAVES AND STEM BARK OF MATOA (POMETIA PINNATA)

Objective: This study aims to investigate the potency of matoa as a tyrosinase inhibitor and antioxidant and also to identify the chemical compounds in the most active fraction and an ethanol extract from the leaves and stem bark of matoa.Methods: The extracts were tested for their tyrosinase inhibitory activity by evaluating the formation of L-dopachrome at 490 nm. Antioxidant activity was tested using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method. The most active extract from liquid-liquid partition analysis was fractionated, and then, the assays were performed.Results: The ethanol extract of leaves and stem bark of matoa showed weak anti-tyrosinase activity (percent inhibition was 24.54±0.22% and 21.93±0.57%, respectively, final concentration 200 μg/mL), but they showed strong DPPH radical scavenging activity (IC50 values were 6.11 μg/mL and 5.47 μg/mL, respectively). The ethyl acetate fraction was the most active fraction with an IC50 value of 5.38 μg/mL. Ethanol extract from the leaves and stem bark of matoa and the ethyl acetate fraction contains flavonoids, tannins, saponins, triterpenoids, and glycosides.Conclusion: Matoa does not have potency as a tyrosinase inhibitor, but it has good antioxidant activity, although still lower than that of quercetin

ANALYSIS OF SYNTHETIC RED DYES IN RED SPINACH SAMPLES (AMARANTHUS TRICOLOR L.)

Objective: The purpose of this study was to determine whether synthetic red dyes are present in red spinach samples.Methods: The presence of the dyes Ponceau 4R, Carmoisine, Rhodamine B, Amaranth was determined in red spinach using reactions, followed bypaper chromatography and thin-layer chromatography (TLC)-densitometry. In paper chromatography analyses, analytes were eluted using n-butanol–ethanol–water (4:5:5) and isobutanol–ethanol–water (3:2:4), and in TLC-densitometry, analytes were eluted with n-butanol–ethanol–water (3:7:1).Results: No synthetic red dyes were found in the seven red spinach samples.Conclusion: The synthetic dyes Rhodamin B, amaranth, Ponceau 4R, and Karmoisin were not found as contaminants of red spinach

SYZYGIUM CUMINI (L.) SKEELS LEAF EXTRACT FRACTIONS AS ARGINASE INHIBITORS AND THE EFFECTS OF TANNINS ON THEIR ACTIVITY

Objective: Arginase inhibition could be a potential therapeutic approach for endothelial dysfunction. Syzygium cumini (L.) Skeels leaves containphenolic acids and flavonoids, which have been predicted to exhibit arginase inhibitory activity. Moreover, these leaves contain tannins, which canform complexes with enzymes and lead to false-positive results during biological testing. Therefore, this study was conducted to evaluate the arginaseinhibitory activity of S. cumini leaf extract and fractions as well as to elucidate the effects of tannins on this activity.Methods: S. cumini leaves were fractionated using n-hexane, ethyl acetate, and methanol. A colorimetric method was employed to evaluate arginaseinhibitory activity. Tannin elimination was performed through the gelatin precipitation method. Total phenolic and flavonoid contents of the fractionswere calculated using the Folin–Ciocalteu and aluminum chloride methods, respectively.Results: Ethyl acetate and methanol fractions showed arginase inhibitory activity with half-maximal inhibitory concentrations (IC50) of 46.96 and15.35 μg/mL, respectively. The methanol fraction was positive for tannins. After tannin elimination, this fraction exhibited less potent arginaseinhibitory activity, with an IC50 value of 53.03 μg/mL. The ethyl acetate fraction showed higher total phenolic and flavonoid contents than the methanolfraction.Conclusion: Tannins affected the arginase inhibitory activity of the methanol fraction of S. cumini leaves; however, the ethyl acetate fraction did notcontain tannins and could inhibit arginase activity

COST-EFFECTIVENESS ANALYSIS OF CEFTRIAXONE-AZITHROMYCIN COMBINATION AND SINGLE LEVOFLOXACIN AS EMPIRICAL ANTIBIOTICS IN COMMUNITY-ACQUIRED PNEUMONIA INPATIENTS AT PERSAHABATAN HOSPITAL

  Objective: Community-acquired pneumonia (CAP) is one of the most common infectious diseases. Its prevalence is especially concerning, as the disease severely impacts health and has a high mortality rate. Although antibiotics have been used to treat CAP, their use is often costly and inefficient. Thus, this study aimed to determine the cost-effectiveness of using ceftriaxone-azithromycin combination and single levofloxacin as empirical antibiotics to treat patients with CAP. Cost-effectiveness was analyzed by comparing the direct total medical cost to clinical effectiveness, which was indicated by the respective success rates in each treatment group.Methods: This study was conducted at Persahabatan Hospital in Jakarta and employed an observational study design, where data were obtained retrospectively from the secondary data contained in medical records for 2014-2016. A total of 100 patients were included in the analysis, with 64 patients using intravenous (iv) antibiotic ceftriaxone and oral azithromycin and 36 patients using iv single levofloxacin.Results: The median costs of antibiotics were significantly different between the ceftriaxone-azithromycin group and the levofloxacin group: Rp.130.756 and Rp.286.952, respectively. The direct total medical cost in the ceftriaxone-azithromycin group (Rp.6.494.998) was higher than that of the single levofloxacin group (Rp.5.444.242). The success rate was 95.3% in the ceftriaxone-azithromycin group and 97.2% in the levofloxacin group, but there were no significant differences between the two groups. The medians for the length of stay (LOS) and length of stay antibiotic-related (LOSAR) measures in the levofloxacin group were 6 and 5 days, which were shorter than the LOS and LOSAR medians in the ceftriaxone-azithromycin group: 7 days and 6 days, respectively. The average cost-effectiveness ratio value in the levofloxacin group was 56.011% effectiveness lower than that of the ceftriaxone-azithromycin group, which was Rp.68.153% effectiveness.Conclusions: Based on these results, it can be concluded that levofloxacin is more cost-effective than a combination of ceftriaxone-azithromycin for treating CAP

CROSS-SECTIONAL STUDY OF ASSOCIATION BETWEEN GLYCEMIC CONTROL AND QUALITY OF LIFE AMONG DIABETIC PATIENTS

Objective: The present study aimed to evaluate the association between glycemic control and quality of life (QoL) in people with type 2 diabetesmellitus (T2DM) and identify that factors that influence glycemic control and QoL.Methods: This cross-sectional study was conducted at the general hospital in Depok City from October to December 2017. Respondents wereoutpatients diagnosed with T2DM, receiving routine care at the hospital. Glycemic control was assessed using glycated hemoglobin (HbA1c) levels,while QoL was measured using an Indonesian version of the validated 5-level EuroQol 5-Dimensional.Results: Among 108 participants, HbA1c levels were influenced by age, DM disease duration, DM treatment adherence, glycemic control, diet, andphysical activity suitable for patients with DM. The mean QoL value was 0.74±0.23 and the visual analog scale (VAS) score was 65.49±15.96. The QoLvalues of patients with DM were influenced by HbA1c levels, duration of DM, and physical activity, while the VAS score was significantly affected byHbA1c levels and duration of DM.Conclusion: The present study showed that the QoL of T2DM patients was significantly influenced by glycemic control and other factors

EFFECTIVENESS OF A MEDICATION BOOKLET AND COUNSELING ON TREATMENT ADHERENCE IN TYPE 2 DIABETES MELLITUS PATIENTS

Objective: This study aimed to evaluate the effectiveness of counseling and the use of a medication booklet on the level of treatment compliancethrough reduced levels of glycated hemoglobin (HbA1C) and Morisky Medication Adherence Scale (MMAS-8) scores in patients with type 2 diabetesmellitus.Methods: This pre-experimental prospectively study was conducted at Dr. Adjidarmo General Hospital, KabupatenLebak, Banten Province, Indonesia.The study sample consisted of 30 type 2 diabetic patients who met the inclusion and exclusion criteria and who underwent a counseling interventionsession and received a medication booklet. Compliance was measured against the MMAS-8 scores and HbA1C levels before the intervention and after10 weeks of administration of counseling and receipt of the booklet).Results: The MMAS-8 scores before and after the intervention were 2.63±1.50 and 0.7±1.18, respectively. The HbA1C levels before and after theintervention were 11.31±2.95 and 8.12±2.79, respectively. The measurement results for MMAS-8 and HbA1C were analyzed using the Wilcoxon test.Conclusions: The analysis showed a significant difference (p<0.001) between the HbA1Cvalues and MMAS-8 scores before and after the intervention.Therefore, this study's finding indicate that the provision of counseling and an informational booklet can improve type 2 diabetes mellitus patientcompliance with treatment

ASSESSMENT OF ANTIBIOTIC PRESCRIPTION IN PATIENTS WITH NON-PNEUMONIA ACUTE RESPIRATORY TRACT INFECTION

Objective: The Ministry of Health (MoH) Regulation No. 30, 2014, about Health Service Standards defines the need for routine monitoring ofprescribing indicators for several diseases, including non-pneumonia acute respiratory tract infection (ARI).Methods: This study compares the results of percentage analysis of the antibiotic usage in patients with non-pneumonia ARI with two methods.Medical record data from April 2016 were collected from Primary Health Care (Puskesmas) Palmerah, West Jakarta.Results: Convenience sampling indicated that 14.28% of patients with non-pneumonia ARIs used antibiotics. Simple random sampling indicatedthat 25% of patients with non-pneumonia ARIs used antibiotics. Differences in sample selection methods affected the final outcome (percentage ofpatients who used antibiotics). The tolerance limit for antibiotic use in non-pneumonia ARIs established by MoH was 20%.Conclusion: These results indicate a need for MoH guidance to pay attention to the sampling techniques used in monitoring the treatment of nonpneumoniaARIs in Primary Health Care